Obtaining appliances, just Boots or everywhere?

[Tony Schofield]

Didn't pharmacies get paid more for dispensing back in the days of on-cost?

In principle no because it was just a mechanism to distribute the global sum. There was also a practice payment paid (basic practice allowance) which for new entrants meant you had to be at least one kilometre from the nearest pharmacy or you didn't get it. It was this that was surrendered for control of entry as a two tier fee was paid. The sliding scale on cost was reduced to 5% so part of that sum of money went into the fee structure..

In actuality however, big dispensing businesses made lamentable profits when purchase profit was taken out. That is not the case now. Small pharmacies had some sort of support from the two tier fee and the essential small pharmacies allowance.

Certainly small pharmacies found it easier to make a living on lower dispensing volumes, particularly as 40% of their turnnover was OTC as opposed to probably 10% now.

However, before we hark back to the "good old days" the white paper has significantly more support now than the Nuffield report of the 1990's which was intended to encourage a more clinical approach from community pharmacy.

It didn't.

[bobbin]

As most scripts costs pence for ingredients, on cost generally not large sum in actual cash. However, when expensive 'ethicals' came into use, on cost became significant to Govnmt. When a crusty old pharmacist said that 'amytal' just as good as new fangled 'Librium'. I remember saying that a couple of dozen amytal were about 9d (old pence) whereas on cost on Librium
at £6/100 would give him much more profit for same amount of work.

25% on cost on Zoladex would be very nice compared with 90p.
johnep

Precisely why appliance contractors (agency schemes) are useful for expensive items but pointless for a couple of Crepe Bandages and a Micropore tape!

[bobbin]

So, I'll leave you with a thought - what will the next tweak be?

Hopefully not the one which pushes us over the edge

I'd like to be more positive but I am concerned that phamacists are expected to take on new services while dispensing volumes are increasing.

[bobbin]

Certainly small pharmacies found it easier to make a living on lower dispensing volumes, particularly as 40% of their turnnover was OTC as opposed to probably 10% now.

So true. Now that you can buy so many medicines at Tesco, often quite cheaply, there is less reason to go to the pharmacy.

[frankiethepill]

Were pharmacies ever paid on-cost? I have very little knowledge of how pharmacies were reimbursed in the olden days!

Yes we were, but it was a depressingly long time ago - 30 years or so. I'm sad that I've been around so long!

[frankiethepill]

Patients with a permanent ostomy are entitled to a 'medical exemption' card. Didn't the patient have one?

You're completely right about direction of prescriptions of course. The stoma nurses are very influential.

Bobbin

No, it was a temporary stoma, i.e. the intention was to reverse, and as such is not exempt.

[frankiethepill]

RE the Relactagel.... you could explain to the patient that it may take quite a while to obtain the product for her and so it might be best to ask the GP for an alternative.

Don't think there is one as Acigel has gone now, but I'm away from any form of reference ATM so might be wrong

[bobbin]

Don't think there is one as Acigel has gone now, but I'm away from any form of reference ATM so might be wrong

Good point. Balance Activ Vaginal Gel is available to buy but it's not allowed on FP10.

Depending on the reason for needing to acidify, something like Zidoval (for bacterial vaginosis) might be suitable. Zidoval is given for 5 days - repeat courses can be given if necessary.

[frankiethepill]

Hopefully not the one which pushes us over the edge

I'd like to be more positive but I am concerned that phamacists are expected to take on new services while dispensing volumes are increasing.

I agree- I try to be positive but my workload keeps on increasing. Have trouble deciding if I'm getting jaded or things are getting more pressured. Numerically the workload has increased but the perceived load increase seems to be greater than the percentages tell me.

[Jeff]

it was a depressingly long time ago - 30 years or so. I'm sad that I've been around so long!

Maybe - but it beats the alternative.

Jeff